Background: Testosterone levels in men decline with age and low testosterone levels or hypogonadism can cause multiple negative effects and symptoms. Studies have shown that exogenous testosterone replacement therapy at physiological levels has a number of beneficial and protective effects on mood, libido, strength, lean body mass, bone health and cardiovascular health. One of the many cardiovascular benefits of testosterone therapy is its action as a vasodilator and effect on angina and exercise induced myocardial ischemia. This purpose of this paper is to review the effects of exogenous testosterone therapy in eugonadal and hypogonadal men with chronic stable angina. All evidence will be evaluated using the GRADE method.
Method: An exhaustive search of available medical literature was conducted through Medline, EBM, and CINHAL databases.
Results: Two randomized controlled trials were reviewed along with the outcome of time to 1mm ST segment depression on treadmill exercise testing. Both studies showed statistically relevant improvements in time to 1mm ST segment depression as well as improvements in total exercise time. Impact on overall quality of life also showed significant improvement verses placebo. Both studies showed an insiginificant increase in Hematocrit and PSA levels but all within normal physiologic ranges. No other adverse effects were seen.
Conclusion: Exogenous testosterone replacement therapy improves overall exercise time and time to 1mm ST segment depression in male eugonadal and hypogonadal patients with angina and myocardial ischemia. Overall GRADE of evidence was considered to be moderate.
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